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Disseminated meningococcal infection in HIV-seropositive patients
A T Nitta1, J M Douglas, G Arakere
1Division of Infectious Diseases, University of Colorado Health Sciences Center, Denver.
Objective:
Although increasing numbers of infections due to various bacterial pathogens have been described in HIV-infected individuals, there have been few reports to date of disseminated Neisseria meningitidis infections in such individuals. We describe here the presentation and clinical course of systemic meningococcal infection in two HIV-1-seropositive men and the response to meningococcal vaccine in one.
Design And Methods:
Retrospective analysis of case reports of two patients identified in a municipal hospital in Denver, Colorado, USA, and evaluation by enzyme-linked immunosorbent assay of antibody response to quadrivalent (A, C, Y, W-135) meningococcal vaccine.
Results:
A 27-year-old HIV-seropositive man with bacteremic group Y meningococcal pneumonia and a 45-year-old man with AIDS and group B meningococcal arthritis both responded to short-term antibiotic therapy without recurrence. The second patient responded to meningococcal vaccination with seroconversion to all four serogroups.
Conclusions:
Disseminated meningococcal infection, although rare in HIV-infected individuals, may present with a variety of clinical manifestations and responds well to antibiotic therapy. Meningococcal vaccine appears to be immunogenic in such individuals.
Insights
Disseminated Neisseria meningitidis infections are rare in individuals with human immunodeficiency virus (HIV). However, these infections respond well to antibiotics, and meningococcal vaccines appear immunogenic in this population.
Area of Science:
- Infectious Diseases
- Immunology
- HIV Medicine
Background:
- While bacterial infections are common in HIV-infected individuals, disseminated Neisseria meningitidis infections are infrequently reported.
- Understanding the clinical presentation and treatment outcomes of meningococcal disease in this vulnerable population is crucial.
Observation:
- This study details two cases of systemic meningococcal infections in HIV-1-seropositive men.
- One patient presented with bacteremic group Y meningococcal pneumonia, and the other with group B meningococcal arthritis and acquired immunodeficiency syndrome (AIDS).
Findings:
- Both patients responded effectively to short-term antibiotic therapy without relapse.
- The patient with AIDS demonstrated seroconversion to all four vaccine serogroups (A, C, Y, W-135) after meningococcal vaccination, indicating a positive immune response.
Implications:
- Disseminated meningococcal infections, though rare in HIV-positive individuals, can manifest diversely.
- Antibiotic treatment is effective, and meningococcal vaccination shows promise for immunogenicity in this patient group.
- These findings support the consideration of vaccination strategies for HIV-infected individuals at risk for meningococcal disease.